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Biomedical subjects

F H Bassett

Publications and source records attributed to F H Bassett.

At least 19 recordsLinked to original sources
PubMed1994

Brachial artery compression by the lacertus fibrosus.

Five patients presented with classic symptoms diagnostic of intermittent claudication that were exacerbated by strenuous activity. Examination demonstrated localized tenderness over the lacertus fibrosus (bicipital aponeurosis), as well as increased pain and an obliterated radial pulse with forearm pronation and resisted elbow flexion. All 5 were athletes who had hypertrophied forearm muscles. Patients were diagnosed with brachial artery compression by the lacertus fibrosus. Release of the lacertus fibrosus restored normal pulses in all cases. Followup ranged from 6 months to 25 years. Full clinical recovery was achieved in 3 patients. One patient had a good result and 1 a fair result. Although the lacertus fibrosus has been well described as a cause of neural compression and compartment syndrome, it has been reported only once to cause intermittent arterial compromise. Hypertrophy of the muscles and the lacertus fibrosus related to excessive use is an important factor in the development of isolated vascular, neural, or combined neurovascular lesions.

Adolescent↗
PubMed1990

Anterior staple capsulorrhaphy for recurrent dislocation of the shoulder: a clinical and biomechanical study.

Thirty-three anterior staple capsulorrhaphies of the shoulder were reviewed at an average 49.7 months postoperatively (range 12 to 127 months); one postoperative dislocation occurred. The patients' quality of athletic participation improved with surgical therapy in 50%, remained the same in 38%, and was lowered in 12%. Average loss of external rotation was 11.4 degrees with the arm adducted and 13.9 degrees with the arm abducted 90 degrees. A positive apprehension sign persisted in 50%. Shoulder function was good or excellent in 84%. Mild pain was admitted by 55%, moderate pain by 6%, and severe pain by 3%. Staple malpositioning or loosening was identified in 12 shoulders; six of these patients had attributable clinical problems. Biomechanical studies in porcine bone were used to demonstrate that predrilling facilitates proper staple positioning without compromising staple fixation strength and, in a synthetic trabecular model, that a 5 degrees variance in the alignment of the staple holder during staple insertion weakens the fixation strength by 51% (P less than .001). The operation usually prevents recurrent dislocation, permits recovery of normal (or near normal) shoulder motion, and allows satisfactory return to competitive athletics. If staple malpositioning and loosening occur, they may cause clinical problems, including degenerative arthritis. Though most patients (92%) stated they would again have the operation, when practical, we recommend other methods of repair of capsule and labral detachment.

Adult↗
PubMed1990

Evaluation of acute traumatic hemarthrosis of the knee joint.

Acute hemarthrosis of the knee usually results from a significant injury. Preoperative assessment, examination under anesthesia, and arthroscopic examination were conducted on patients with a total of 132 acutely injured knees associated with hemarthrosis and minimal clinical laxity to determine the presence and extent of injury to ligamentous and/or intra-articular structures. Partial or complete tear of the anterior cruciate ligament was found in 101 (77%) of the knees. Peripheral meniscal tears were responsible for the hemarthrosis in 17 cases (13%), and osteochondral fractures were found in 11 cases (8%). Injury to the anterior cruciate ligament was frequently associated with concomitant injury to other structures: meniscal tears (61%), ligament/capsular injury (40%), and hyaline chondral damage (16%). Patients' responses to preoperative anterior drawer, pivot shift, and Lachman tests were within normal limits in 18%, 29%, and 73% of cases, respectively. Patients under anesthesia responded to the anterior drawer and pivot shift tests normally 50% and 74% of the time. The Lachman test, performed under anesthesia, was 98% accurate in predicting anterior cruciate injury. Experience gained in evaluating posttraumatic hemarthrosis of the knee suggests clinical examination alone may not demonstrate the severity of many of these injuries. Arthroscopy, although not necessary to determine competence of the anterior cruciate ligament, is invaluable in determining the existence of other injuries with or without an associated anterior cruciate ligament tear.

Acute Disease↗
PubMed1990

Jumper's knee. Diagnosis and treatment.

"Jumper's knee" or patellar tendinitis was first described in an article by Blazina in 1973. He noted an increasing incidence of peripatellar tendinitis, affecting either the quadriceps tendon or the patellar tendon insertion onto the patella, most commonly in jumping athletes. Since that time, numerous articles have further defined the etiology of this condition and the actual pathologic lesion, along with classifying the stages of its development and outlining appropriate methods of treatment and prevention. Although jumper's knee is quite common, its treatment remains somewhat controversial. This paper reviews the current trends in treatment and presents the authors' experience with an aggressive but simple surgical approach in highly competitive athletes that can yield gratifying results for both the athlete and physician.

Athletic Injuries↗
PubMed1990

Team physician #9. The role and responsibilities of the competition physician.

The rapid growth of participation in contact sports has been accompanied by an increasing need for sporting event coverage by qualified physicians. The competition physician must not only be capable in contemporary emergency and sports medicine, but must also have organizational skills to coordinate satisfactory medical and ancillary backup. This monograph outlines a comprehensive plan for efficient preparation and execution of on-site sports injury assessment and care. With knowledge, organization, and preparation, competition coverage can be a satisfying component of a sports medicine practice.

Athletic Injuries↗
PubMed1990

Talar impingement by the anteroinferior tibiofibular ligament. A cause of chronic pain in the ankle after inversion sprain.

Seven patients who had pain in the anterior aspect of the ankle were found to have a thickened distal fascicle of the anteroinferior tibiofibular ligament. Each patient had a history of an inversion sprain of the ankle followed by chronic pain in the anterior aspect of the ankle. The thickened distal fascicle was resected without loss of stability of the ankle. Five patients needed débridement of an area of abraded hyaline cartilage on the anterolateral aspect of the talus. Six patients were followed for a mean of thirty-nine months (range, twenty-four to fifty-nine months). Four of them had no pain in the ankle or limitation in activities, and two reported marked improvement, with only occasional pain in the ankle related to overuse. A separate distal fascicle of the anteroinferior tibiofibular ligament is present in most human ankles and can be a cause of talar impingement, abrasion of the articular cartilage, and pain in the anterior aspect of the ankle. Resection of this ligament usually will alleviate the pain caused by the impingement.

Adult↗
PubMed1990

Team physician #8. Osteochondritis dissecans of the patella in a competitive fencer. A case report and review of the literature.

Osteochondritis dissecans of the patella, a rare condition producing knee pain in the athlete, is considered to be the result of repeated shear forces producing microtrauma. We present the case of a fencer who developed this injury. The confirmation of the diagnosis by magnetic resonance imaging scan is demonstrated, and the literature is reviewed with an emphasis on treatment. The physician treating athletes with anterior knee pain must consider this entity in making the differential diagnosis.

Adolescent↗
PubMed1990

Luxatio erecta: the inferior glenohumeral dislocation.

Luxatio erecta, or inferior glenohumeral dislocation, is a rare shoulder dislocation usually caused by a hyperabduction injury to the arm. We have reviewed the literature consisting of 80 cases of luxatio erecta and also discuss six additional cases that we have treated. The literature shows that either a fracture of the greater tuberosity or a rotator cuff tear was associated with this injury in 80% of patients; 60% of the patients reviewed sustained some degree of neurologic compromise, most commonly to the axillary nerve. These injuries usually resolved; the time for recovery varied from 2 weeks to 1 year. Only 3.3% of the cases demonstrated significant vascular compromise, but this is the highest incidence for any shoulder dislocation. Doppler studies of the affected arm or observation of the patient overnight are recommended because of the potentially disastrous complications of vascular insufficiency. If there is any indication of a vascular problem, immediate arteriogram is indicated. Although usually fairly easily reduced by overhead traction, the lesion is so rare that few physicians are familiar with the technique of reduction. Fluoroscopy was used in our most recent cases and was helpful in obtaining a complete and safe reduction.

Adolescent↗
PubMed1985

Recurrent dislocation of the patella treated by the modified Roux-Goldthwait procedure. A prospective study of forty-seven knees.

We studied the results in forty-seven knees in thirty-seven patients - ten male and twenty-seven female - who had recurrent dislocation of the patella and were treated by a modified Roux-Goldthwait procedure (lateral retinacular release, medial transfer of the lateral patellar tendon without advancement, plication of the medial retinaculum, and advancement of the vastus medialis). Ten of the female patients had bilateral dislocation. The results were analyzed after follow-ups ranging from 3.0 to 16.3 years (average, 5.8 years). The study confirmed that a tangential radiograph of the patellofemoral joint, made with the knee in 20 degrees of flexion, is reliable in determining patellar displacement. The results were excellent in twelve knees, good in thirty-one, fair in one, and poor in three. The fair and poor ratings were due to pain caused by severe chondromalacia patellae. The patient with a fair result had had recurrent dislocations after the Roux-Goldthwait procedure due to a very lax synovial and capsular sac. Reoperation with tightening of the sac medially and laterally eliminated hypermobility of the patella in this patient and established straight patellar tracking. There was one serious complication, a large subcutaneous hematoma with necrosis of a skin flap. The patients with mild chondromalacia improved and showed no progressive patellofemoral arthritis after simple realignment, while those with severe chondromalacia were not improved by shaving, drilling, and realignment. Preliminary results indicated that a modified Maquet procedure, in addition to realignment, may be indicated for patients with severe chondromalacia. This study demonstrated that the modified Roux-Goldthwait procedure, without advancement of the tibial attachment of the patellar ligament, can stabilize the patella without increasing patellofemoral compression. The procedure does not relieve the symptoms of severe chondromalacia of the patella but realignment is the first step in treatment of any form of patellofemoral arthrosis.

Adolescent↗
PubMed1982

Herpes simplex infection involving the hand.

Finger lesions caused by the herpes simplex virus often resemble pyogenic infection and must be differentiated from the latter to avoid unnecessary surgical drainage. The lesions, with their accompanying symptoms and signs, resolve spontaneously within one to three weeks, and only supportive treatment is necessary. Recurrence is not unusual, occurring as late as several years after the original attack. Most patients with herpetic whitlow are medical or dental personnel, whose occupation requires contact with the oral-respiratory system of patients. Therefore, direct digital contact with individuals infected by oral herpes simplex or with asymptomatic carriers is the most plausible mechanism of transmission of the virus. Avoidance of the disease in such highly infectious persons is possible by the use of gloves.

Adolescent↗
PubMed1982

Compression of the musculocutaneous nerve at the elbow.

From 1965 to 1981, eleven patients with compression of the sensory portion of the musculocutaneous nerve by the biceps aponeurosis and tendon were seen at Duke University Medical Center and followed until the completion of treatment. Four patients responded to non-operative management. Compression of the nerve by the biceps aponeurosis and tendon against the fascia of the brachialis muscle accounted for the characteristic finding of nerve-flattening and loss of vascular markings in the seven patients who required surgery. Surgical decompression relieved the symptoms in all seven of them.

Adolescent↗
PubMed1980

Knee examination.

Based on a comprehensive and systematic knee evaluation, the clinician can develop an effective individualized rehabilitation program. Goals are established for the patient by examining their individual needs and allowing adequate progression as directed by the patient's response and ongoing status. The patient should be subjectively and objectively reassessed at each treatment session and have any necessary modifications made in this program at that time.

Anthropometry↗
PubMed1980

Diagnosis and treatment of the plica syndrome of the knee.

Seventy-three knees with a symptomatic plica were managed using both conservative and operative methods. Twelve patients were successfully treated conservatively. Fifty-seven patients (sixty-one knees) underwent arthrotomy and partial synovectomy or a release of the plica through the operating arthroscope, and all but two returned to full activity. The results were considered excellent or good after an average follow-up of nineteen months.

Adult↗
PubMed1978

Arthroscopic examination of the knee. Polypuncture technique with percutaneous intra-articular manipulation.

Many of the limitations of conventional diagnostic arthroscopy of the knee have been largely overcome through the development of techniques that permit manipulation of intra-articular structures through paired, coordinated entry sites. Ten accessory entry sites are described. This technique was tested in sixty-three fresh knees from cadavera and was employed in fifty-eight knees of ninety patients who required arthroscopy between September 1976 and July 1977. The technique provided information of diagnostic significance that was not obtainable on preliminary conventional arthroscopic examination in 74 per cent of the clinical trials, and it resulted in no complications. It increased the accuracy and realiability of diagnostic arthroscopy of the knee and at times helped to avoid an exploratory arthrotomy while facilitating the planning of therapeutic arthrotomy.

Adult↗